CASE 71 (January 2012)

Clinical information

The patient is a 11-year-old boy. He presented nephrotic syndrome at 3-year-old, with complete response to steroids. Two recurrence episodes at 4 years of age. Asymptomatic since then. Now he is evaluated due to edemas. On laboratory tests was found hypoalbuminemia, dyslipidemia and proteinuria: 300 mg/m2/h. Blood cells count was normal. Tests for viruses: Negative. Serum complement: normal. ANA, ANCA: Negative.

With diagnosis of recurrent nephrotic syndrome, a renal biopsy was undertaken. See the images.

Figure 1. H&E, X100.

Figure 2. H&E, X400.

Figure 3. H&E, X400.

Figure 4. PAS stain, X400.

Figure 5. Masson's trichrome stain, X400.

Figure 6. Methenamine-silver stain, X400.

Figure 7. Methenamine-silver stain, X400.

Direct immunofluorescence for IgA, IgG, IgM, C3, C1q, kappa, and lambda: Negative.

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